Punjab

Ludhiana

CC/21/477

Harjeet Kaur - Complainant(s)

Versus

United India Insurance Company Limited - Opp.Party(s)

Harpreeet Singh

20 Aug 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                             Consumer Complaint No:  477 dated 18.10.2021.                                       Date of decision: 20.08.2024. 

 

Harjeet Kaur Sandhu aged about 41 years wife of Jagdeep Singh, resident of 218, Highway Enclave, G.T. Road, Jagraon, District Ludhiana.                                                                                                             ..…Complainant

                                                Versus

United India Insurance Co. Ltd., 24, whites Road, Chennai-600014(India).

2^nd address:

United India Insurance Co. Ltd., service claims hub, divisional office no.5, 3^rd floor, the mall, Surya tower and mall road, Ludhiana-141001.                                                                                                               …..Opposite party 

Complaint Under Section 36 of the Consumer Protection Act for directing the opposite party to pay Rs.8,59,368/- as claim amount for accidental tipper bearing RC no.RJ-13-GB-2660 which was insured vide policy no.2010033120P103437776 dated 07.07.2020 to 06.07.2021 and Rs.2,00,000/- as compensation amount for causing physical harassment, unnecessary delay in claim, mental stress, agony, depriving the complainant, deficiency in service.

QUORUM:

SH. SANJEEV BATRA, PRESIDENT

MS. MONIKA BHAGAT, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant             :         Sh. Gaurav Prabhakar, Advocate.

For OP                           :         Sh. D.R. Rampal, Advocate.

 

 

 

 

 

ORDER

PER SANJEEV BATRA, PRESIDENT

1.                Shorn of unnecessary details, the facts of the case are that the complainant is the owner of tipper bearing RC No.RJ-13-GB-2660 which was insured with the OP vide policy No.2010033120P103437776 dated 07.07.2020 to 06.07.2021. On 06.02.2021, the said tipper was being driven by the driver Gurmej Singh son of Surinder Singh, R/o. Mullanwal Paswal, Distt. Gurdaspur from Mulanpur to Garshankar via Ludhiana. The said vehicle was on National Highway between Mulanpur and Ludhiana, accident occurred due to dense fog when it struck against a tipper wrongly parked on the road. In the said accident, the front portion of the tipper was damaged up to huge extent. The OP was informed about the accident who sent a surveyor at the spot for verification and inspection of the damaged tipper. The surveyor prepared an estimate of Rs.8,59,368/- and demanded some share from the estimated amount to which the complainant refused to give. The complainant further stated that he provided all the documents to the OP as per their demand.  Further he personally met officials of the OP who assured the complainant to do the needful within 2-3 days but later on no response was received from the OP. The complainant sent legal notice dated 24.06.2021 to the OP. The OP sent reply dated 20.07.2021 to which reply dated 27.08.2021 was sent by the complainant. Hence this complaint whereby the complainant has prayed for issuing direction to the OP to pay the claim amount of Rs.8,59,368/- along with compensation of Rs.2,00,000/-.

2.                Upon notice, the OP appeared and filed written statement and assailed the complaint by taking preliminary objections on the ground of maintainability; non-joinder and mis-joinder of necessary parties; the complainant being not come with clean hand; suppression of material facts; the complaint being premature etc. The OP stated that the policy issuing office Industrial Area “B” above Allahabad Bank, Near Partap Chowk, Ludhiana and governing office of this branch i.e. Divisional Office No.IV, Savitri Complex, Ludhiana of the OP are necessary parties but they have not been impleaded. The Op further stated that it sent one reply dated 20.07.2021 through Sh. Rajan Kumar Chand, Advocate calling upon the complainant to supply the certain documents and in response to said reply dated 20.07.2021, the complainant sent reply dated 27.08.2021. The complainant has filed the present complaint without awaiting their decision and as such, the claim of the complainant is required to be treated as No Claim.

                   On merits, the OP reiterated the crux of averments made in the preliminary objections and facts of the case. However, the OP admitted the ownership and issuance of policy qua tipper No.RJ-13-GB-2660 and its liability to pay the damages is towards the vehicle bearing chassis No.00575, Engine No.132214 and not for another vehicle. The OP stated that the before issuance of the policy valid for the period of 07.07.2020 to 06.07.2021 the inspection was got conducted by them on the vehicle of the complainant and M/s. AKCM Ins. Auxillary Private Limited conducted the inspection who gave Commercial Inspection Report Inspection dated 06.07.2020 with respect of the vehicle registered in the name of Harjeet Kaur bearing Registration No.RJ-13-GB-2660, bearing Chassis No.00575, Engine No.32214. The Insurance Policy bearing No.2010033120P103437776 valid for the period of 07.06.2020 to 06.07.2021 was issued by Branch Office, Industrial Area "B", Above Allahabad Bank, Near Partap Chowk, Ludhiana of the OP and said policy also shows the Chassis No.00575 and Engine No.132214 of the said vehicle. The R/C of the vehicle has been also showing the same chassis number and engine number of the said vehicle registered in the name of Harjeet Kaur. One intimation dated 06.02.2021 was given on behalf of complainant Harjeet Kaur and the OP deputed one Mr. Rahul Sethi for Spot Survey and M/s U.P.S. Sachdeva for surveyor and assessment of the vehicle. Mr. Rahul Sethi did the survey on the same i.e. 06.02.2021 and he also found that physically chassis number and engine number of aforesaid vehicle are not matching with the chassis number and engine number mentioned in registration certificate (R/C) and from this it is clear that vehicle which was having Chassis No.00575 and Engine No.132214 is not involved in any accident and there was no damages to the said vehicle having Chassis No.00575 and Engine No.132214. The said surveyor also took the photographs at the spot. M/s U.P.S. Sachdeva & Company did the survey on 09.02.2021 and on the subsequent dates and it also gave one interim report dated 16.02.2021 of the vehicle in question. The surveyor also pointed out chassis and engine number of the vehicle are not matching which were mentioned in the R/C of the vehicle. The said surveyor also issued one registered letter dated 09.02.2021 demanding required documents as mentioned in letter dated 09.02.2021 from the insured. The insured supplied some documents through courier to the surveyor but she had not sent all the required documents and accordingly said surveyor M/s. U.P.S. Sachdeva & Company again posted one registered letter dated 10.06.2021 to the complainant demanding said documents. The said surveyor submitted its Motor Final Survey Report dated 14.06.2021 and he has specifically mentioned that no police report was lodged by the complainant and even as per spot survey report the chassis number and engine number of the vehicle are not matching with the engine number and chassis number of the vehicle mentioned in the R/C. However, the said surveyor has assessed the loss considering all aspects of the case. The vehicle was of Model 2015 and as per terms and conditions of insurance policy and by following the guidelines laid down by the head office and registered office of the OP, the said surveyor assessed the loss of the vehicle at Rs. 1,84,000/- and said loss was also assessed without prejudice to the rights of the insurance company and subject to terms and conditions of the insurance policy. M/s G.P.S. Associates submitted re-inspection report dated 12.07.2021. Investigator Third Eyes submitted his investigation report dated 28.05.2021 On receipt of which the OP issued one letter dated 29.06.2021 demanding required documents and again reminder dated 15.07.2021 was issued to the complainant demanding certain documents and clarification on certain points which are reproduced as under:-

1. “RC of vehicle bears Chassis No.00575 and Engine No. 132214 but as per survey done by the surveyor it bears Chassis NO.00681 & Eng. No. 156896 please clarify.
2. Permit in respect of goods provided is for Rajasthan State Please provide National permit.
3. Please provide Claim Form duly filled and signed.
4. Please provide TP affidavit, permit authorization, KYC duly filled and signed along with mandatory documents mentioned therein.
5. Please provide Medical Report of Driver driving the vehicle at the time of accident.
6. Please provide Bills of repairs done to vehicle as well as payment receipt & Neft details.
7. As per Investigation Report Engine & Cabin have been replaced. Engine plate shown by repairer was having no specification number please clarify.”

 

The OP further stated that the complainant was requested to provide the above said documents and clarification at the earliest to process her caim but she has failed to provide said documents and information. Even the notice dated 24.06.2021 got served by the complainant through her counsel Mr. Harpreet Singh Sidhu, Advocate was duly replied by the OP through their advocate Sh. Rajan Kumar Chand, Advocate vide reply dated 20.07.2021, the copy of which was also sent to the complainant and she was specifically pointed out with regard to status of her case and she has been specifically informed that she had not supplied the required documents and clarifications as per letter dated 15.07.2021 as mentioned above. In reply to said reply, the complainant has sent reply dated 27.08.2021 to the reply dated 20.07.2021 got served by the OP through their counsel and along with said reply some documents were also sent. Even the vehicle was not possessing all India Permit. The vehicle was only having the permit of Rajasthan State, but it was not possessing National Permit. Even the chassis number and engine number are not matching with the chassis number and engine number as mentioned in the R/C of the vehicle. In reply dated 27.08.2021 the complainant has stated that in 2019 due to technical default in the engine of the vehicle the complainant purchased old parts and changed only body of engine not whole engine. But no such change was got conducted in the registration certificate of the vehicle. Even Commercial Inspection Report Inspection dated 06.07.2021 is showing same chassis number and engine number as mentioned in the R/C of the vehicle at the time of inspection, meaning thereby the vehicle which was damaged is not insured by the OP and insurance company is not liable to pay any compensation. The OP further stated that even the present complaint is pre-mature as the complainant did not wait for their decision and filed the present case in haste. Further the facts pointed out in present case are showing that vehicle which was insured bearing specific chassis number and engine number is not damaged, so claim of the complainant is to be treated as no claim and complainant is not entitled to any compensation/damages. The OP has denied that there is any deficiency of service and has also prayed for dismissal of the complaint.

3.                In evidence, the complainant tendered her affidavit as Ex. CWA and reiterated the averments of the complaint. The complainant also placed on record documents Ex. C1 and Ex. C2 are the photographs of the vehicle, Ex. C3 is the copy of invoice dated 28.06.2021 of Sonakshi Motors Pvt. Ltd., Ex. C4 is the copy of account statement of the complainant, Ex. C5 is the copy of legal notice dated 24.06.2021, Ex. C6 is the copy of reply dated 27.08.2021 to reply dated 20.07.2021 of legal notice, Ex. C7 is the copy of RC No.RJ13-GB-2660, Ex. C8 is the copy of certificate of fitness of the vehicle, Ex. C9 is the copy of Goods Permits Part-B, Ex. R10 is the copy of insurance policy w.e.f. 07.07.2020 to 06.07.2021 and closed the evidence.

4.                On the other hand, the counsel for the OP tendered affidavit  Ex. RA of Sh. Sanjeev Kumar, Senior Divisional Manager of the OP as well as affidavit Ex. RB of Sh. Rahul Sethi, Surveyor & Loss Assessors, Village Daad, Ludhiana and affidavit Ex. RC of Sh. U.P.S. Sachdeva, The Chief Executive of M/s. U.P.S. Sachdeva & Co. Model Town, Ludhiana along with documents Ex. R1 is the copy of Commercial Inspection Report dated 06.07.2020 of AKCM Insu. Auxiliary Pvt. Ltd., Ex. R2 is the copy of certificate of insurance w.e.f. 07.07.2020 to 06.07.2021, Ex. R3 is the copy of policy schedule w.e.f. 07.07.2020 to 06.07.2021, Ex. R4 is the copy of intimation by the complainant, Ex. R5 is the copy of Email dated 09.02.2021, Ex. R6 is the copy of Email dated 02.08.2021, Ex. R7 is the copy of certificate of fitness, Ex. R8 is the copy of Goods permit Part-A, Ex. R9 is the copy of Goods permit Part-B, Ex. R10 is the copy of Tax Clearance Certificate, Ex. R11 is the copy of pollution certificate, Ex. R12 is the copy of spot survey report of Sh. Rahul Sethi, Surveyor, Ex. R13 to Ex. R32, Ex. R43 to Ex. R60, Ex. R63 to Ex. R82,  are the copies of photographs, Ex. R33 is the copy of invoice issued by Rahul Sethi, Surveyor, Ex. R34, Ex. R95 is the copy of estimated bill dated 08.02.2021 of Sonakshi Motors Pvt. Ltd., Ex. R35 is the copy of interim report dated 16.02.2021 of surveyor U.P.S. Sachdeva & Co., Ex. R36 is the copy of letter dated 09.02.2021 issued by U.P.S. Sachdeva & Co. to the complainant, Ex. R37 is the copy of postal receipt, Ex. R38 is the copy of letter dated 10.06.2021 issued by U.P.S. Sachdeva & Co. to the complainant, Ex. R39 is the copy of postal receipt, Ex. R40 is the copy of Motor Final Survey Report dated 14.06.2021 of U.P.S. Sachdeva & Co., Ex. R41 is the copy of loss assessment made by U.P.S. Sachdeva & Co., Ex. R42 is the copy of Survey Fee Bill of U.P.S. Sachdeva & Co., Ex. R61 is the copy of Reinspection letter dated 12.07.2021 issued by G.P.S. Associates to the OP, Ex. R63 is the copy of survey fee bill dated 12.07.2021 of G.P.S. Associates, Ex. R83, Ex. R84 are the copies of letters dated 29.06.2021, 15.07.2021 issued by the OP to the complainant, Ex. R85 is the copy of reply dated 20.07.2021 to legal notice dated 24.06.2021, Ex. R86 and Ex. R87 are the copies of postal receipts, Ex. R88 is the copy of reply dated 27.08.2021 to reply dated 20.07.2021 sent by the OP, Ex. R89 is the copy of Envelop, Ex. R90 is the copy of RC No.RJ-13-GB-2660, Ex. R91 is the copy of permit, Ex. R92 is the copy of Motor Claim Intimation, Ex. R93 is the copy of PAN Card of the complainant, Ex. R94 is the copy of Aadhar Card of the complainant, Ex. R96 is the copy of cheque dated 13.07.2021 issued by the complainant in favour of Sonakshi Motors Pvt. Ltd., Ex. R97 is the copy of investigation report dated 28.05.2021 of Third Eye Investigators and closed the evidence. 

5.                We have heard the arguments of the counsel for the parties and also gone through the complaint, affidavit and annexed documents and written statement along with affidavits and documents produced on record by both the parties.

6.                The complainant being owner of Tipper bearing registration No.RJ13-GB-2660 obtained a Motor Insurance – Goods Carrying Commercial Package vide policy certificate Ex. R2 (Policy Schedule Ex. R3) w.e.f. 07.07.2020 to 06.07.2021. The IDV value of the vehicle was to the tune of Rs.20,00,000/-. On 06.02.2021, the vehicle in question met with an accident due to dense fog on National Highway between Mulanpur and Ludhiana when it struck against a tipper standing on the road due to which the insured vehicle got damaged. At that time, the vehicle was being driven by the driver Gurmej Singh son of Surinder Singh. Intimation dated 06.02.2021 Ex. R4 was given to the OP and a claim was lodged with the OP vide claim intimation Ex. R92. The OP appointed Sh. Rahul Sethi for spot survey who submitted his spot survey report Ex. R12, the relevant part of which is reproduced as under:-

                   “9. Cause & Nature of accident:

As per insured, while going on the road, when at near the spot of accident, suddenly a front going tractor trolley applied brakes and insured’s truck hit with trolley from front side, resulted insured’s truck got damaged.

17. Remarks:

c) The vehicle was empty at the time of accident.

d) Driver is not present at the time of survey, kindly check the medical report of the driver.

e) Chassis Number and Engine Number physically not match with RC.”

The OP also appointed M/s. U.P.S. Sachdeva & Co., Surveyors and Loss Assessors who vide his letter dated 09.02.2021 Ex. R36 demanded certain documents from the complainant, which are reproduced as under:-

1. “Claim form duly filled and signed.
2. Detailed estimate of Loss (original).
3. Original RC book for verification and return.
4. Original Driving licence for verification and return.
5. Copy of police report, if lodged, if not give reason.
6. Copy of Route Permit, fitness, load challan/G.R., PUC Certificate.
7. Signature ID Proof i.e. Pan Card or Passport
8. Copy of insurance policy. (Current & previous)
9. KYC form of insured & One Passport Size Passports.
10.  Please let us know the reason why you have instructed the repairer to dismantle the vehicle without inspection of survey.
11.  Detail about T.P. loss if any.
12.  Any other information pertaining to the claim.”

 

The said surveyor vide his letter dated 10.06.2021 Ex. R38 acknowledged the receipt of some documents from the complainant except duly filled & signed claim form and details of permit including previous permit details. The surveyor U.P.S. Sachdeva initially submitted his Interim Report dated 16.02.2021 Ex. R35 and later on submitted Motor Final Survey Report dated 14.06.2021 Ex. R40 and assessed the loss to Rs.1,84,000/- vide Loss Assessment Ex. R41. The Surveyor/Investigator vide its report Ex. R40, made the following conclusion:-

                   “Conclusion of investigator:

                   There is no dispute on Insurable interest on Insured.

                   Accident has established.

Driver is identified as Mr. Gurmej Singh s/o. Surinder Singh. No evidence/cue found which confirm that he was driving the vehicle under influence of any intoxicant.

Replacement of major Parts - Cabin and Engine - established. None of them has any identification plate.

Insured has admitted the replacement of these parts with Disposal Part – which were probably un-used, but old ones. It is the prerogative of Final Surveyor to comment on their cost and other replacements.

No TP Loss reported.”

 

The OP further appointed Third Eye Investigators, Jalandhar who submitted its investigation report dated 28.05.2021 Ex. R97 and made the identical findings made in the report Ex. R40.

7.                Now the point of consideration arises for consideration before this Commission that whether the complainant is entitled to the accidental claim with regard to the insured vehicle?

8.                It is apposite to mention that before awaiting any decision of the OP regarding his claim, the complainant preferred to file the present complaint. Further before filing the present complaint, the complainant sent a legal notice dated 24.06.2021 Ex. C5 to the OP through her counsel Sh. Harpreet Singh Sidhu, Advocate, calling upon to make the payment of insurance claim amount within stipulated period mentioned in the legal notice. The OP vide its reply dated 20.07.2021 Ex. R85 to legal notice Ex. C5 asked the complainant to submit clarification and to submit certain documents, which is reproduced as under:-

“1. RC of vehicle bears chasis number 00575 and engine no.132214 but as per survey done by the surveyor it bears chasis no.00681 & Eng. No.156896-Please clarify.

2. Permit in respect of goods provided is for Rajasthan State-Please provide National permit.

3. Please provide Claim Form duly filled and signed.

4. Please provide TP Affidavit, permit authorization KYC duly filled and signed along with mandatory documents mentioned therein.

5. Please provide Medical Report of Driver driving the vehicle at the time of accident.

6. Please provide Bills of repairs done to vehicle as well as payment receipt & NEFT details.

7. As per Investigation report Engine & Cabin have been replaced. Engine plate shown by the repairer was having no specification number-Please clarify.”

 

Further the complainant sent rejoinder dated 27.08.2021 Ex. C6 = Ex. R88 vide which the complainant attached/annexed the documents as demanded by the OP vide reply dated 20.07.2021 Ex. R85. The relevant part of Ex. C6 = Ex. R88 is reproduced as under:-

“a) RC of vehicle.

b) Permit in respect of goods provided is for Rajasthan State.

c) Claim form.

d) PAN card and Aadhaar Card.

e) No major injury to driver therefore no need of medical report.

f) Bill of repair & cheque.

g) In 2015 the said vehicle purchased by my client from a Russian company wind up whole business from India. In 2019 due to technical default in engine of said vehicle my client purchased old parts and changed only body of engine. Till date chasis number is same.”

 

The OP has acknowledged the receipt of documents from the complainant i.e. Ex. R90 is the copy of RC of the vehicle, Ex. R91 is the copy of Goods Permit issued by Transport Department, Rajasthan, Ex. R92 is the copy of Motor Claim Intimation, Ex. R93 is the copy of her PAN Card, Ex. R94 is the copy of her Aadhar Card, Ex. R94 is the copy of estimation bill dated 08.02.2021 of Sonakshi Motors Pvt. Ltd., Ex. R96 is the copy of cheque of Rs.8,59,369/-n dated 13.07.2021 issued in name of Sonakshi Motors Private Limited as well as submission of clarification regarding medical report of the driver as well as change of chassis number of the vehicle.

9.                It is established on record that the vehicle in question, duly insured with the OP, met with an accident, which was found to be genuine by the surveyors as well as investigators appointed by the OP on receipt of timely intimation from the complainant. The claim of the complainant could not be settled for want of certain documents and clarifications demanded through letter Ex. 09.02.2021 (Ex. R36), letter dated 10.06.2021 Ex. R38 of U.P.S. Sachdeva & Co. as well as reply to legal notice dated 20.07.2021 Ex. R85. The insurance companies are required to be more liberal in their approach without being too technical while settling the genuine claims.

10.              In this regard, reference can be made to 2022(2) Apex Court Judgment 281 (SC) in case title Gurmel Singh Vs Branch Manager National Insurance Company Ltd. whereby it has been held by the Hon’ble Supreme Court of India that the insurance company has become too technical while settling the claim and has acted arbitrarily. The appellant has been asked to furnish the documents which were beyond the control of the appellant to    procure and furnish. Once, there was a valid insurance on payment of huge sum by way of premium and the Truck was stolen, the insurance company ought not to have become too technical and ought not to have refused to settle the claim on non­-submission of the duplicate certified copy of certificate of registration, which the appellant could not produce due to the circumstances beyond his control. In many cases, it is found that the insurance companies are refusing the claim on flimsy grounds and/or technical grounds. While settling the claims, the insurance company should not be too technical and ask for the documents, which the insured is not in a position to produce due to circumstances beyond his control.

                   As such, in the given set of circumstances, it would be just and proper if the complainant is directed to submit the available documents as demanded through letter Ex. R38 as well as reply Ex. R85 with the OP within 30 days from the date of receipt of copy of order and after the receipt of the documents from the complainant, the OP shall settle and pay the claim within a period of 30 days from the date of receipt of documents from the complainant. Further if the complainant is not in possession of remaining documents, then the OP shall settle and pay the claim to the complainant on the basis of already submitted documents within 45 days from the receipt of copy of this order.

11.              As a result of above discussion, the complaint is partly allowed with direction to the complainant to directed to submit the available documents as demanded through letter Ex. R38 as well as reply Ex. R85 with the OP within 30 days from the date of receipt of copy of order and after the receipt of the documents from the complainant, the OP shall settle and pay the claim within a period of 30 days from the date of receipt of documents from the complainant. Further if the complainant is not in possession of remaining documents, then the OP shall settle and pay the claim to the complainant on the basis of already submitted documents within 45 days from the receipt of copy of this order. However, there shall be no order as to costs. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

 

 

12.              Due to huge pendency of cases, the complaint could not be decided within statutory period.

 

 

(Monika Bhagat)                              (Sanjeev Batra)               Member                                         President  

Announced in Open Commission.

Dated:20.08.2024.

Gobind Ram.